Online Program

Impact of a Routine HIV Screening Policy and Program in an Urban Academic Emergency Department

Wednesday, November 4, 2015 : 11:06 a.m. - 11:18 a.m.

Cammeo Mauntel-Medici, MPH, Department of Emergency Medicine, University of Illinois at Chicago, Chicago, IL
Sara Baghikar, MD, MPH, Department of Emergency Medicine, University of Illinois at Chicago, Chicago, IL
Janet Lin, MD, MPH, University of Illinois at Chicago, College of Medicine, Chicago, IL
Issues: Routine HIV screening in Emergency Departments (EDs) has been recommended by the Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) for over 9 years, but is still not widely implemented in EDs throughout the United States. We describe a routine HIV screening policy and program and its impact on HIV screening practices in an urban ED.

Description: Our routine HIV screening policy ensures that patients age 13-64 are offered opt-out HIV screening during their ED visit. Our program increased HIV education for providers and established a screening model that utilizes an algorithm in the electronic medical record (EMR) to screen patients for eligibility and generate an electronic order for providers to offer opt-out screening for eligible patients. The testing model streamlined the process of determining patient eligibility, documenting consent, and ordering the HIV test. As a result, HIV testing in our ED increased 8757.14% within 2 months of program implementation, with a previous average of 7 tests performed monthly and a current average of 620 tests performed monthly.

Lessons Learned: Routine HIV screening in an urban ED is feasible and accepted among providers. Routine HIV screening policies and programs can facilitate rapid improvement in screening practices. Utilization of EMR prompts and automated orders facilitates efficient integration of routine screening into ED workflow and minimizes burden for ED staff. Routine HIV screening plays an important role in identifying ED patients who are HIV positive, unaware of their status, and may have otherwise been discharged undiagnosed. 

Recommendations: EDs should establish routine HIV screening policies and programs in order to integrate HIV screening into their existing workflow and increase early diagnosis of HIV infection. EMR technologies and innovations should be utilized to improve the efficiency, acceptability, and sustainability of routine screening programs.

Learning Areas:

Administer health education strategies, interventions and programs
Administration, management, leadership
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public
Public health administration or related administration
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Describe strategies for integrating routine HIV testing in an emergency department setting. Identify potential impact of routine HIV testing policies on patient outcomes. Explain the importance and role of emergency departments in early HIV diagnosis.

Keyword(s): HIV/AIDS, Emergency Medical Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: With a background and training in public health I have extensive knowledge and experience with preventive health services and programming. In my current position as Project Manager of Project HEAL (HIV testing, Education, Awareness, and Linkage to care) it is my responsibility to serve as an expert on HIV/AIDS preventive services and best practices, and to develop HIV/AIDS curriculum and educational materials.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.